Heat stroke

Woollybear

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Hey,

I have a character who isn't sleeping well, and he is doing some manual labor on a hot roof, and as things stand now he passes out on the roof. Partly from the heat and partly from the lack of sleep. Someone finds him like that, helps him off the roof and they go inside to recover him.

He's groggy, but comes around. I wan't trying to give him heat stroke, but maybe I did. According to google, I gave him heat exhaustion. For example, he is sweating hard.

^^ But. My critique circle said that he had an episode of heat stroke and that it would have more severe ramifications than what I wrote. (When I was writing I did not ever have the thought 'this is heat stroke' ... more the thought 'this kid isn't getting the sleep he needs and the roof is too damn hot.' )

But maybe I gave him heat stroke without meaning to. I wonder if I should make the incident more mild. My goal is to have a twenty minute recovery inside be sensible.

Heat exhaustion is usually accompanied by a fever no higher than 104 degrees Fahrenheit, excessive thirst, nausea, fainting, cool and clammy skin, weakness, muscle aches, heavy sweating, slow heartbeat and dizziness. Heatstroke may develop following heat exhaustion if the condition is not treated.

https://www.childrenscolorado.org/c.../parenting-articles/heat-exhaustion-symptoms/

From my research about the two conditions my writing on that part is fine as stands. He has heat exhaustion not stroke. I was really surprised that several people said I had an instance of heat stroke. I can't figure out what the detail was that tipped them to that conclusion. Maybe I should have the guy that rescues him call it out directly as heat exhaustion.

Any thoughts about this?
 
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Woollybear

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I think I have a solution. We can let this question roll off the bottom.
 

blacbird

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Just as a point: both heat stroke and heat exhaustion are extremely dangerous conditions that can be fatal.* I'd just pick one or the other, give the symptoms in your story, and take it where it needs to go.

caw

*A very close friend of mine named David Johnson, valedictorian of my high school class and an all-state track and field athlete, went to Yale on a dual academic/athletic scholarship. A few days before his graduation, he was playing recreational tennis on a hot day in New Haven, developed heat exhaustion and died at age 21.
 

Enlightened

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I researched this, a little, last year and found this information from this video: https://www.youtube.com/watch?v=kTmLetF-GS4

Exhaustion symptoms.... Heavy sweating; dizziness; nausea; headache; fast heartbeat; and dark urine.

Heat stroke symptoms.... High fever, severe headache, dizziness/lightheadedness; red skin; no sweating/dry skin; muscle weakness/Cramps; Nausea/Vomiting; fast heartbeat; fast breathing; confusion/disorientation; and seizures.
 
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Woollybear

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Thanks, and I am sorry to hear about David. That is horrible.

My character definitely had mild exhaustion not stroke. I've clarified it further in the narrative and dialogue now. He wasn't ever dehydrated - that had already been directly called out with having water earlier. He was sweating profusely - also directly called out.

But I clarified it further in narrative - the guy that pulls him down is commenting on heat exhaustion as my character comes back to consciousness. Then the guy asks him if he has a headache or muscle cramps and he says no to each.

Not stroke.

So I think it's all good now, mild heat exhaustion. He's groggy in the following scene, which allows him to reveal some info he might not otherwise.
 
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Enlightened

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She later goes on....

Heat stroke....

1. Leads to organ failure then death.
2. Skipping breakfast increases the risk of heat exhaustion and heat stroke.

3. 24 hours before going out, start drinking water. Stay hydrated.
4. Drink constantly; do not gulp. Sweating dehydrates. Do not drink just water (leads to water intoxication without electrolytes).
5. Drink at least one sports drink.
 

lonestarlibrarian

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I was standing on the side of a football field when I had heat exhaustion once. It was part of my freshman Welcome Week tours in undergrad, where they were showing us around-- so it was the first or second week of August, and very hot.

I don't remember much about it-- I was kind of hot and tired, but I vaguely noticed I'd stopped getting all sweaty, and then suddenly, the color went out of my vision and everything was in grays, and it was what I'd describe as being "pixellated"-- details went sort of blocky and chunky. About the same moment, I lost my ability to hear. I kind of clung on to my friend I was standing next to, feeling like I was about to slide down. And then the next thing I knew, I'd been carried into the locker room, laid out on a table, and the staff gave me damp rags and some bottled drinks. (Water?) They made me sit there for a few minutes, and then my friend and I rejoined our group. No headache, no cramps, nothing stuck around, just the memory of feeling your senses go haywire for a few moments, and then blanking.

But if that was just heat exhaustion, I can imagine that full-fledged heat stroke would be very distressing.

However, I'd be really cautious about trying to "help someone off a roof" who isn't at full capacity (or who is at zero capacity), unless I was trained, like a fireman. A lot would depend on whether it was a flat roof or a pitched roof, and whether there were other people nearby who could help send things like towels/drinks/whatever up the ladder, and who could help the person stay still until they were able to safely wrangle a ladder.
 

Woollybear

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That's a good point. I'll make sure the rescue has a few appropriate details. Thanks.
 

jclarkdawe

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However, I'd be really cautious about trying to "help someone off a roof" who isn't at full capacity (or who is at zero capacity), unless I was trained, like a fireman. A lot would depend on whether it was a flat roof or a pitched roof, and whether there were other people nearby who could help send things like towels/drinks/whatever up the ladder, and who could help the person stay still until they were able to safely wrangle a ladder.

Been there, done that. It's not fun. One story house and it probably wouldn't be too bad. We had a two story house with no access to a ladder truck. Ended up strapping him in a stokes basket, running a rope over the roof to the other side, and slowly lowered him down a ladder. Took about ten of us and a lot of patience.

There's not a lot you can do on a pitched roof as far as first aid. A flat roof is a bit better. On a pitched roof, unless he's attached, he's likely to go right over the side.

Unless you know what you're doing, helping someone down a ladder is not something you want to do. There is a technique involved, and usually you'll need a couple of people.

Jim Clark-Dawe
 

Woollybear

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I brought out a contractor just now and he pulled a section of roof down real low for me. That's where the kid will start on the task. They had a ladder before, and there's plenty of damp cloths, but I think you guys are right, it would be too unwieldy. A low section of roof is easy enough.
 

R.A. Lundberg

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I've witnessed both heat exhaustion and heat stroke cases. Heat exhaustion is bad, but not usually fatal (Blacbird's friend David is a tragic exception to that.) One thing about heat exhaustion is that it can really make any underlying health issues you might have, like a heart murmur, much more threatening while you are weakened by it. Heat stroke is absolutely life threatening, even to young, strong people, and can have other effects like organ or brain damage. Heat exhaustion usually clears up after a cooling off/rehydrating period, while heat stroke cases frequently wind up hospitalized.
 

neandermagnon

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If you just want your character to pass out on the roof after not getting enough sleep and working hard, it doesn't have to involve either heat stroke or heat exhaustion. (It can if you want, but doesn't have to!)

Both heat stroke and heat exhaustion happen when the core body temperature is too high. I don't know Fahrenheit (sorry!) but in centigrade, the normal body temperature is around 37. Anything above 37.5 is high. If it's caused by an infection, it's fever (the body raises the temperature deliberately to help fight the infection). If it's caused by the environment, i.e. the body's trying to keep the temperature at 37 degrees, but it's too hot and can't lose the extra heat so the core body temperature goes up, then that's heat exhaustion. If it gets to 40 degrees, that's heat stroke. Centigrade degrees are bigger than Fahrenheit degrees. 38 is a low fever and 39 is a high fever. 40 is dial 999.

It is totally plausible that someone could pass out in the circumstances described while their core body temperature is still 37 degrees (i.e. not have heat exhaustion or heat stroke). When you exercise, you feel hot, but feeling hot isn't because your core body temperature's gone up. It's because more of your blood goes to your skin (vasodilation) and you sweat more, in order to dissipate the heat. Mostly, if someone feels too hot from exercising, they'll slow down or stop and try to cool down. You might feel ill at that point (heavy exercise can make you feel ill if it's more than what you're used to), while your core body temperature is still within the normal range. Heat exhaustion can happen if you're unable to cool down (e.g. because it's too hot or humid, or if, for whatever reason, you carry on exercising regardless - especially if it's hot or humid), but it's not inevitable. And feeling ill and too hot from exercise doesn't mean you have heat exhaustion.

You can pass out from exercise for various reasons, even on a cold day. Low blood pressure or your body failing to equalise blood pressure after changes in posture/types of exercise can cause someone to pass out. Low blood sugar also can do this. For example, at the moment at my rugby club we're doing boot camp style training as it's the off season. I've got to the point where I felt like I was about to pass out a few times, and it's not been hot at all. In my case, it's low blood pressure. Some exercises (e.g. those involving lifting heavy objects) causes rapid changes in blood pressure. Suddenly stopping an exercise can cause a drop in blood pressure (when you move your legs, it helps the blood go back to your heart. If you stop moving your legs suddenly, less blood is getting back to your heart) which can cause you to pass out. I have to be very careful about this. Keeping my legs moving between exercises (walking back and forth rather than just stopping and standing still) prevents me from feeling like I'm going to pass out. If someone hasn't had enough to eat then that also can make them pass out, or increase the risk of them passing out as a result of blood pressure changes.

Going back to your critique group, if the only info they've got is that this guy's passed out working on a roof on a hot day, and they're saying "he has heat exhaustion/heat stroke" - well, they're not doctors... just because it's hot doesn't mean he's got heat stroke. If you want him to be fine shortly after passing out, then maybe the cause can be a combination of low blood pressure, low blood sugar and lifting heavy stuff then suddenly stopping. This is not a medical emergency (as long as he doesn't fall of the roof as a result!). He'll only be unconscious for a few seconds, then he'll start to come round, feel groggy for a while, but if he lies still for a while with his feet up, sits up slowly, has some water and something to eat with sugar in it, he'll start to feel better. He won't need an epic or dramatic rescue off the roof. He'll be able to get himself off the roof when he starts to feel a bit better, albeit it's a good idea if someone goes down with him in case he feels faint again. Just don't make him be unconscious for a long period of time! Unfeasibly long periods of unconsciousness when it's not medically plausible is a common way that writers mess up stuff like this.

Note: if he has lost consciousness for more than a few seconds in your story, this would explain why the critique group think he's got heat stroke.
 
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cornflake

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You're not recovering from either in 20 minutes.

I don't understand what a lack of sleep has to do with the heat exhaustion or passing out.
 

DarienW

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I'm not writing about either condition, but thank you all for sharing your personal experiences. So interesting, and who knew, so dangerous. So sorry to hear about David. :(

I do think you're fine with your example Patty. I wouldn't question it myself. I was sleep deprived after college and actually fell asleep behind the wheel. Took hitting the curb to wake me, and thankfully, give me some adrenaline.

Hope this helps!

:)
 

novicewriter

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That happened to me in second grade. The school decided to make all the students go outside for 15+ minutes when it was around 90+ degrees, for a fire drill. When I was feeling the heat exhaustion, I wanted to go back inside, but I couldn't because the school wouldn't allow it. So, my body collapsed, and I suddenly remember waking up on the ground with sand on my face, with my teacher lifting me in her arms.

My family wasn't originally from there, where it becomes very hot in the spring and summer months, which, when I was older, read could end up affecting even adults who aren't used to the heat.

The school nurses blamed me, which infuriated me, saying I must've not drunk enough water during lunch or eaten enough and told me that from now on, I needed to drink more water (even though my teachers didn't allow students to leave the classroom whenever they wanted, just to drink water from the water fountains).

I don't remember them apologizing; only my teacher was worried. They said I didn't need to be sent to the hospital and just cooled my body down with wipes and gave me water to drink, so I was just sent home, with my mother. I'd been at that school for at least a year, eaten my lunch and drank liquids, and hadn't ever had any problems, before. They were the ones who forced me to go outside in the heat when the sun was beating down, during a time when the local news warns people to stay indoors or watch exercising or exerting themselves. I was fine until I was forced to wait outside in the heat for several minutes.
 
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Woollybear

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The idea of him being given a glass of sweetened water on the roof before coming down is a good one. That can also be the location where the other guy asks about headache and muscle cramp. That makes sense.

Since we're in the tired man's point of view, we don't know how long he was out. A few seconds is fine.

So, that's all good. Thanks everyone.
 
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WeaselFire

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If you just want your character to pass out on the roof after not getting enough sleep and working hard, it doesn't have to involve either heat stroke or heat exhaustion. (It can if you want, but doesn't have to!)

Simple dehydration. 20 minutes resting in the shade and a couple of bottles of Gatorade and he's good to go. From the been there, done that category.

Jeff
 

Norman Mjadwesch

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This happened to me two summers ago. It was horrifically hot and high humidity, and a friend of mine needed to get a fence completed before the end of the week. We did everything right: regular hydration, loose protective clothing, broad hat, not working too hard. None of it made any difference. After just two hours of pottering about I started feeling nauseous and weak, I couldn't even carry a shovel or walk in a straight line. Because we were in a remote location, my friend tried to convince me that we should quit for the day (he wanted to take me to the hospital). Instead, all I did was sit under a shady tree for about two hours, and when we had a thunderstorm in the afternoon the temperature cooled and I started improving. I was really weak for about two days, and spent a fair bit of that time in bed. I'm nearly fifty now, which may have attributed to my condition, but when I was younger I used to do this sort of activity for a living and never had a problem.
 

MichaelC

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In heat exhaustion you see flush skin, sweating, dizziness, and is less severe than heat stroke. In heat stroke you have lack of sweating, hot skin, hyperthermia (increased body temperature), coma, and death.